This course provides advanced practitioner clinical experience. Emphasis is placed on therapeutic and diagnostic patient care. Upon completion, students should be able to demonstrate clinical competence in required performance evaluations.

Prerequisites: RCP 111.

Corequisites: RCP 210.

Class Hours: 0        Lab Hours: 0        Clinical/Work Exp.: 18        Credit Hours: 6


Continue to practice all therapeutic modalities utilized in RCP 113, RCP 135, and RCP 111.

In a critical care setting, assess the patient's cardiopulmonary status by inspection to determine

  • General appearance h. breathing pattern.

  • Peripheral edema.

  • Diaphoresis.

  • Digital clubbing.

  • Cyanosis.

  • Chest configuration.

  • Diaphragmatic excursion.

  • Breathing pattern.

  • Accessory muscle activity.

  • Asymmetrical chest movement.

  • Intercostal / sternal retractions.

  • Nasal flaring.

  • Character of cough.

  • Amount and character of sputum.

In a critical care setting, assess the patient's cardiopulmonary status by palpation to determine

  • Heart rate, rhythm.

  • Asymmetrical chest movement.

  • Airway secretions.

  • Endotracheal tube placement.

  • Crepitus.

In a critical care setting, assess the patient's cardiopulmonary status by auscultation to determine

  • Bilateral, normal breath sounds.

  • Abnormal breath sounds.

  • Adventitious breath sounds.

In a critical care setting, interview the patient to determine

  • Level of consciousness.

  • Orientation to person, place and time.

  • Emotional state.

  • Ability to cooperate.

Perform and interpret results of the following diagnostic procedures

  • Pulse oximetry.

  • Minute volume/tidal volume.

  • Maximum inspiratory pressure.

  • Peak flow.

  • Forced vital capacity.

  • Spirometry before/after bronchodilator.

  • Timed forced expiratory volumes.

  • Lung mechanics.

  • Alveolar ventilation.

  • Tracheal tube cuff pressure.

  • Blood gas analysis.

Inspect the patient's chest radiograph to determine the position of the endotracheal or tracheostomy tube

Conduct therapeutic procedures to achieve adequate arterial and tissue oxygenation

  • Initiate and adjust BiPAP/CPAP.

  • Initiate and adjust PEEP therapy.

Explain planned therapy and goals to the patient in understandable terms to achieve optimal therapeutic outcome

Determine the appropriateness of the prescribed respiratory care plan, recommend modifications where indicated, and participate in the development of the respiratory care plan

Communicate information regarding the patient's clinical status to appropriate members of the healthcare team

In the critical care setting, evaluate and monitor the patientís response to respiratory care

  • Review chest x-ray when appropriate.

  • Monitor mean airway pressure.

  • Obtain blood from arterial lines.

  • Measure lung compliance and airway resistance.

  • Measure A-a Gradient.

Demonstrate the ability to perform quality control procedures for blood gas analyzers

Conduct therapeutic procedures to achieve maintenance of a patent airway, including the care of artificial airways

  • Select endotracheal or tracheostomy tubes.

  • Change tracheostomy tubes.

Conduct therapeutic procedures to achieve adequate mechanical ventilation

  • Initiate and adjust continuous mechanical ventilation.

  • Initiate and adjust combinations of SIMV, PEEP therapy, pressure support, and pressure control ventilation.

In the home care setting, the student will receive exposure to and perform when appropriate

  • O2 delivery devices used in the home setting.

  • Home mechanical ventilation.

  • Reimbursement/billing procedures.

  • Patient assessment.

  • BiPAP/CPAP equipment, delivery and set up.

Demonstrate proficiency, professionalism, and competency in performing respiratory care procedures by being able to

  • Participate by asking appropriate questions.

  • Exhibit courtesy and willingness to share workload.

  • Exhibit dependability by being present, punctual, and completing the assigned workload.

  • Exhibit the ability to work cooperatively with a variety of people in the health care setting.

  • Respond positively to supervision and guidance.

  • Exhibit an ability to communicate effectively with other members of the health care team.

  • Exhibit respect for others.

  • Manage time efficiently and effectively.

  • React to stressful situations in an appropriate manner.

  • Recognize limitations and boundaries of role, and seek assistance when necessary.

Adhere to infection control policies and procedures to protect patients from nosocomial infections


A Excellent 4 Grade Points Numerical grade of 90 - 100
B Above Average 3 Grade Points Numerical grade of 80 - 89
C Average 2 Grade Points Numerical grade of 70 - 79
D Below Average 1 Grade Point Numerical grade of 60 - 69
F Failed 0 Grade Point Numerical below 60
WP Withdraw Passing 0 Grade Point Issued if the course is dropped after the
census date and on or before the 60% point
of the course unless the instructor issues
a WF based on extenuating circumstances
WF Withdraw Failing 0 Grade Point Issued if the course is dropped after the
60% point of the course or the instructor
chooses based on extenuating circumstances


Regular, prompt attendance is essential for academic success. Students should strive for perfect attendance. It is recognized, however, that students may be absent from class occasionally. Students should reference the instructor's syllabus to determine the attendance requirement for this course. The instructor is responsible for enforcing the attendance requirement. It is the student's responsibility to withdraw from the course. Students may complete the withdrawal process in the Advising Center. Students may receive a grade of WP if they withdraw from a course by the 60% point/date of the course. Any student withdrawals that occur after the 60% point will result in a grade of WF. Exceptions to the "WF" grade may exist if the student has a mitigating circumstance. Students are encouraged to discuss withdrawal options with the faculty member and complete the withdrawal process in the Advising Center.


If you have a documented disability and wish to discuss academic accommodations, please contact Frank Pait, Counselor for Students with Disabilities, at extension 4222, in the Learning Assistance Center (LAC) located on the first floor of the Cuyler A. Dunbar Building (CAD).

If you are a student with a mobility impairment and have a class in a multi-story building, please discuss evacuation plans with your instructor.


Students shall be permitted excused absences from all classes two days per academic year for religious observances required by their faith. The absences requested in accordance with this policy are "one of" and not "in addition to" any absences otherwise permitted by the faculty for a class. The excused absence request must be submitted by the second class meeting and a minimum of two (2) weeks in advance of the absence. Please contact your instructor for the required forms.


Students at CVCC are expected to be honest in all academic pursuits, whether class, lab, shop, or clinical. Acts of academic dishonesty are considered unethical and subject to behavior sanctions. Examples of academic dishonesty include, but are not limited to the following:

1. Sharing information about the content of quizzes, exams, classroom/lab/shop/clinical assignments (scheduled or make-up) without approval of the instructor including but not limited to unauthorized copying, collaboration, or use of notes, books, or other materials when preparing for or completing examinations or other academic assignments (scheduled or make-up).

2. Buying, selling, or otherwise obtaining a copy of a quiz, exams, project, term paper, or like document, without approval of the instructor.

3. Plagiarism, which is defined as the intentional representation of another person's work, words, thoughts, or ideas (from any source) as one's own.

4. Failing to follow approved test taking procedures by performing such acts as:
  • Looking on another student's test
  • Use of unauthorized notes; written, electronic, or otherwise
  • Changing answers after exam is scored
  • Verbal, non-verbal, or electronic communication with another student during an exam

Instructors have the authority to impose either a warning, probation, or dismissal from the class for acts of academic dishonesty relative to classes under their supervision.

Students have an obligation to report any acts of academic dishonesty to the instructor or appropriate campus authority when reasonable grounds exist for such a report. Students also have a responsibility to cooperate in the investigation of any alleged acts of academic dishonesty. Failure to report acts of academic dishonesty could result in a behavior sanction as outlined in the Student Conduct Policy, Policy 3.18


Reporting and Response to Sexual Violence, Sexual or Gender-based Harassment, and Other Sexual Misconduct

"Title IX Violations" is the term that will be used to include "sexual violence, sexual or gender-based harassment, and other sexual misconduct" and is explained further in Procedure 3.18.2. The Procedure can be found on the CVCC Website under About Us/Procedures.

Procedure 3.18.2 applies exclusively to Title IX Violations allegations. All other forms of harassment and/or discrimination are handled under Policy 3.18: Student Code of Conduct.

Students and/or employees are encouraged to report Title IX Violations in any of its forms, including, but not limited to, sexual or gender-based harassment, rape, sexual assault, other forcible and non-forcible sex offenses, domestic or dating violence, or stalking, and CVCC supports this procedure for students and employees in compliance with Title IX legislation.

Any student who believes that he or she is being, or has been subjected to, Title IX Violations is encouraged to file a report of the alleged Title IX Violations promptly with the Title IX Coordinator, Dean for the School of Access, Development, and Success.


To Report a Serious Emergency Dial 911 from any campus phone or 911 from mobile phones; then dial 711 (Campus Safety & Security) from a campus phone.

For specific CVCC emergencies guidelines, please refer to the CVCC Emergency Guidebook


Quickly get all persons behind a locked door, close blinds, lock all windows/doors, and turn off lights. Sit against an interior wall away from windows and doors (hide). Keep cell phones ON in silent mode or vibrate. Do not leave the locked area until notified by a known CVCC administrator or by law enforcement that the emergency is over.

Seek Shelter (tornados, hurricanes, etc.)
Move to hallways and/or other inner rooms. Stay away from windows and doors. Sit on floor facing the inner wall and shield head with hands. Remain in shelter until notified by CVCC administration or by emergency personnel that the danger is over.

Building Evacuation
Leave the building immediately and proceed to a parking lot location at least 300 feet from the building. Do not delay to retrieve books or other personal items. Do not use elevators. Do not touch suspicious objects. Stay clear of the building once outside. Faculty should take class rosters if possible and account for all students at evacuation locations. Report any special assistance needed to CVCC faculty/staff or to emergency personnel. If you are aware or suspect someone is trapped in a threatened building, notify CVCC faculty/staff or emergency personnel. Remain at your building evacuation location until further instructions are provided by CVCC administration or by emergency personnel. In case of bomb threat, avoid using cell phones and wireless devices; this may detonate the bomb.

Smoke, Fire or Hazardous Materials
Activate the nearest fire alarm. Before attempting to fight a fire, notify someone nearby. Never attempt to fight a fire larger than wastebasket size. Close doors and windows to isolate the problem if the situation permits. If trapped in a building during a fire, use wet towels or cloths to protect you from flames and smoke. Stop/drop/roll if your clothes catch on fire. Do not open doors that feel hot. Always stay between the fire and an exit. Stay low to the floor as you try to exit.

Personal Emergencies
Unless you feel threatened, stay with the victim until emergency personnel arrive. Avoid contact with bodily fluids. Stay calm and try to minimize panic. If the person is conscious, ask if he/she is a High School student (if so, include this information in your 911 call).

Emergency Procedures Revised: April 4, 2012

Cell phone backup to 711 Campus Safety & Security:

Printer Friendly Version of RCP 236